Provider Demographics
NPI:1114400207
Name:WESTER CUZA, LESLY (APRN)
Entity type:Individual
Prefix:
First Name:LESLY
Middle Name:
Last Name:WESTER CUZA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 VONDERBURG DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5968
Mailing Address - Country:US
Mailing Address - Phone:813-681-5658
Mailing Address - Fax:813-681-5250
Practice Address - Street 1:500 VONDERBURG DR STE 102
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5968
Practice Address - Country:US
Practice Address - Phone:813-681-5658
Practice Address - Fax:813-681-5250
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013358363L00000X
FLRN9485908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty